Depression tied to increased mortality in IPF

Patients with idiopathic pulmonary fibrosis (IPF) and comorbid depression are less likely to initiate antifibrotic treatment and thus face an increased risk of death, as reported in a study.

Researchers used data from the National Database of Health Insurance Claims and Specific Health Checkups of Japan and looked at 31,386 patients with IPF. They calculated the prevalence of depression at IPF diagnosis, determined its postdiagnosis incidence rates, and assessed its associations with mortality and antifibrotic therapy. Propensity score matching, landmark analysis, and a Cox model with time-dependent covariates were performed.

The prevalence of depression at IPF diagnosis was 6.7 percent, and the annual incidence rate postdiagnosis was 32.4 cases per 1,000 person-years.

Pre-existing depression showed no association with mortality (hazard ratio [HR], 0.978, 95 percent confidence interval [CI], 0.887–1.080). On the other hand, depression occurring after IPF diagnosis was associated with a more than twofold increase in mortality risk (HR, 2.71, 95 percent CI, 2.55–2.87).

Likewise, depression occurring after IPF diagnosis was linked to a lower cumulative initiation rate of antifibrotic therapy, whereas pre-existing depression had no impact on cumulative initiation rate.

The findings underscore the importance of integrating mental healthcare into comprehensive management strategies for IPF in order to improve patient outcomes, the researchers said.